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    Lecture 42 - IDA & Iron Overload

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    Iron is an essential mineral that is important for red blood cell production and oxygen transport. Iron deficiency anemia is caused by low iron stores and is the most common type of anemia worldwide. It results in microcytic hypochromic anemia due to insufficient heme synthesis. Diagnosis involves blood tests showing low hemoglobin, hematocrit, MCV and ferritin levels along with elevated RDW and TIBC. Treatment involves iron supplementation and treating the underlying cause. Other types of anemia discussed are anemia of chronic disease and iron overload disorders.

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    Lecture 42 - IDA & Iron Overload

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    Iron is an essential mineral that is important for red blood cell production and oxygen transport. Iron deficiency anemia is caused by low iron stores and is the most common type of anemia worldwide. It results in microcytic hypochromic anemia due to insufficient heme synthesis. Diagnosis involves blood tests showing low hemoglobin, hematocrit, MCV and ferritin levels along with elevated RDW and TIBC. Treatment involves iron supplementation and treating the underlying cause. Other types of anemia discussed are anemia of chronic disease and iron overload disorders.

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    Iron is an essential mineral that is important for red blood cell production and oxygen transport. Iron deficiency anemia is caused by low iron stores and is the most common type of anemia worldwide. It results in microcytic hypochromic anemia due to insufficient heme synthesis. Diagnosis involves blood tests showing low hemoglobin, hematocrit, MCV and ferritin levels along with elevated RDW and TIBC. Treatment involves iron supplementation and treating the underlying cause. Other types of anemia discussed are anemia of chronic disease and iron overload disorders.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    347 views50 pages

    Lecture 42 - IDA & Iron Overload

    Uploaded by

    api-3703352
    Iron is an essential mineral that is important for red blood cell production and oxygen transport. Iron deficiency anemia is caused by low iron stores and is the most common type of anemia worldwide. It results in microcytic hypochromic anemia due to insufficient heme synthesis. Diagnosis involves blood tests showing low hemoglobin, hematocrit, MCV and ferritin levels along with elevated RDW and TIBC. Treatment involves iron supplementation and treating the underlying cause. Other types of anemia discussed are anemia of chronic disease and iron overload disorders.

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    of 50

    Objectives

    • Why is iron important


    • The body iron cycle (absorption, transfer,
    distribution)
    • Causes and features of iron deficiency
    anemia (IDA)
    • Diagnosis and management of IDA
    • Anemia of chronic disease
    • Iron overload
    Anemia- Causes
    • Blood loss • Excessive Destruction of
    – hemmorhage RBC’s
    – bleeding disorder – RBC membrane defects
    • spherocytosis
    • Inadequate production
    – RBC enzyme defects
    of RBC’s
    • G6PD deficiency
    – Fe deficiency
    – Hemoglobinopathies
    – lead poisoning • thalassemia alpha or beta
    – Folate, B12 deficiency – Sickle cell disease
    – Bone marrow failure – Drugs
    – Bone marrow – Infections
    infiltration
    – Renal causes
    • Anemia of chronic disease
    Iron Deficiency Anemia:
    • The commonest type of anemia worldwide

    • Cause: low iron stores in the body

    Iron is important in heme synthesis in Hb. molecules

    Heme = protoporphyrin + iron


    Dietary sources of iron
    Sources of iron
    Heme iron: Meat,
    fish, liver
    Fe+2

    Non-heme iron:
    Vegetables
    Fe+3
    Iron absorption:
    duodenum,
    jejunum
    The
    distribution
    of iron in
    tissue
    The Iron Cycle
    Receptor-mediated transferrin endocytosis
    Transferrin Receptor
    Absorption of Iron

    – Duodenum, jejunum
    Absorption of Iron

    • Vit C, amino acids promote absorption


    • Gastric acid helps in solubility
    • Tea, veg. fiber decrease absorption
    Pallor
    Angular Stomatitis
    Iron Deficiency Anemia - Koilonychia
    Laboratory evaluation
    of IDA

    • Blood smear
    • Iron studies for iron deficiency
    • Bone marrow iron stores
    Iron deficiency anemia is a
    microcytic hypochromic anemia

    • Microcytes – when MCV <80 fl.


    Microcytic Anemia (IDA)
    Iron Deficiency Anemia:
    Iron Deficiency Anemia:
    Status
    iron
    transferrin
    Prussian Blue Stain
    of Bone Marrow

    Iron Present No Iron Present


    Iron Deficiency Anemia - Diagnosis
    • Low Hb, HCT, MCV, MCH, smear
    • retic count relatively low
    • High RDW – Red cell Distribution Width
    • Plt count high
    • Low serum iron, high TIBC,
    • Low serum ferritin
    • Low transferrin saturation
    • transferrin saturation <15% excellent test
    • FEP (free erythrocyte protoporphyin): high
    • stool for occult blood
    Low MCV and Low Retics
    Differential diagnosis

    • Iron deficiency
    • Sideroblastic anemia
    • Thalassemia trait
    • Lead poisoning
    • Anemia of chronic disease
    Management of IDA
    • Treat underlying cause
    • Replacement therapy
    ferrous sulfate or gluconate

    • Transfusion: rarely needed


    ACD

    IDA
    Normal
    Hemosiderosis
    Hemochromatosis
    • is a genetic disease in which
    the body accumulates excess
    amounts of iron
    • Serious and sometimes fatal
    health problems may result
    from the excess iron that
    accumulates in the body
    • arthritis, cirrhosis of the
    liver, diabetes, heart failure,
    and liver cancer
    F e r r it in

    R educed N o rm a l In c re a s e d

    I r o n d e f ic ie n c y H B e le c t r o p h o r e s is A n e m ia o f C h r o n ic D is e a s e B o n e m a rro w
    R in g e d s id e r o b la s ts

    If HB electrophoresis is normal then


    do alpha gene mapping
    Further investigations to find the
    cause are necessary

    Hypochromia
    Microcytic

    Note: Anisocyosis: RDW


    poikilocytes

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